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About this blog: The Raucous Caucus shares the southpaw perspectives of this Boomer on the state of the nation, the world, and, sometimes, other stuff. I enjoy crafting it to keep current, and occasionally to rant on some issue I care about deeply... (More)

About this blog: The Raucous Caucus shares the southpaw perspectives of this Boomer on the state of the nation, the world, and, sometimes, other stuff. I enjoy crafting it to keep current, and occasionally to rant on some issue I care about deeply. My long, strange career trip has included law and management jobs in two Fortune 50 companies, before founding the legal search and staffing firm Cushing Group, Recruiters. I've lectured on negotiation and settlement strategy, and teach graduate courses at Golden Gate University (Adjunct of the Year for a doctoral seminar on business, law and society). Illinois, Texas and California (Inactive) admitted me to law practice; I hold JD and MBA degrees from the University of Illinois, and a BGS from the University of Michigan, with Distinction. There -- Go Blue! Personally, my daughters are a lawyer in NY, and a pre-med student in NM - their lives-and-times often animate these columns. I'm active in animal advocacy matters, having led a citizen team that took Alameda's city animal shelter to a non-profit operation - we saved $600K annually and the lives of some 700 companion animals/year vs. the City's best alternative. I'm delighted with that success. My family has re-homed 144 foster animals over many years; we host four boisterous border collies of our own. Mostly for humane movement efforts, I was nominated for GQ magazine's 2009 Better Men, Better World Award. You may notice that many of my rants relate to critter issues. In addition to the Raucous Caucus blog, I frequently contribute to The BARK magazine, and am a proud Moderator emeritus on the popular news and humor website www.Fark.com. I prefer scotch over imported beer (Hide)

Call Alice ...

One pill makes him larger, and
One pill lights your spark.
But the promises Big Pharma gives you,
Too-o-oo often miss the mark ? *

Newsflash: the FDA has given its regulatory blessing to the 'Addyi' pill, the so-called 'female Viagra' -- or, as one wag put it, "finally, a cure for the common headache."

Except it's neither.

Now, I don't mean to be insensitive to anybody's sexual tribulations -- 'tis said that sex is a lot like oxygen -- not a huge deal unless it's in short supply. In bygone days, sufferers of such romantic hypoxia might have included a lot of gasping married folk, but somebody called Ashley Madison seems to have solved that problem for untold millions (not all by herself, of course, and her 32 million clients are apparently no longer 'untold').

What I want to curmudge here are various phenomena associated with these preciously pink oblong pills.

First, the term 'female Viagra' -- it's inaccurate. Those several related, male-oriented pharmaceuticals operate on a strictly, uh, mechanical level. They deal with plumbing and its obstructions, and leave libido to the imagination where it belongs, as well as all those free sites on the web. I'm told. Think of them as a kind of Drano that is supposed to work in four hours or fewer. Addyi, by contrast, apparently acts on biochemical balances in the brain -- particularly the mix of dopamine and serotonin.

That difference is likely to perpetuate the claim that absent ardor is all in the head of the female partner. Haven't we had enough of that sort of misogyny, "wherever" in a woman's body it's directed? That it's somehow her 'fault' she doesn't feel like tripping the dark fantastic?

Conversely, there's all those ill-humored adversarials who find evidence of systemic bias in the late arrival on the scene of this particular concoction. Finally, Big Pharma gets around to women, they say, before thinking much about it -- if this was a male problem, a solution would've been found long ago ? oh wait. Sexual dysfunction is not either party's individual problem; it's a couples thing -- two to tango, regardless of whether folks are standing or prone.

Then there's the warning that daily-use Addyi does not play nice with alcohol. Per the FDA approval announcement: "Because of a potentially serious interaction with alcohol, treatment with Addyi will only be available through certified health care professionals and certified pharmacies," continued Dr. Woodcock (You're kidding, right FDA? No?) "Patients and prescribers should fully understand the risks associated with the use of Addyi before considering treatment."

The announcement continues: 'Addyi can cause severely low blood pressure (hypotension) and loss of consciousness (syncope). These risks are increased and more severe when patients drink alcohol or take Addyi with certain medicines that interfere with the breakdown of Addyi in the body. Because of the alcohol interaction, the use of alcohol is contraindicated while taking Addyi. Health care professionals must assess the likelihood of the patient reliably abstaining from alcohol before prescribing Addyi.'

So, mixing this chemical with alcohol renders women unconscious? Sadly, there's already a pill for that, colloquially called 'roofies.' Do we really need to add another weapon to the abuse arsenal of placekickers and other sexual predators?

Further, the alcohol interaction study relied-on by the FDA was a sample of twenty-five people ? 23 of whom were men. According to researcher Lori Brotto, quoted in New York magazine: "Gender differences in the metabolism and toxicity of alcohol are well known, and women are more susceptible to toxicity effects than are men, As such, I think the negative interactions between Addyi and alcohol found in the safety study are understated, and in women taking Addyi, I would expect the mixing to be more devastating." Remember that girl who drank you under the table in college? (I do, sort of.) Well, she's not typical.

Finally, there's the ultimate question of does Addyi really work? The first thing to note is that it took three dates with the FDA approvers, along with an extensive lobbying campaign directed at the agency (which may have included candy and flowers), to score the regulators' blessing. Courtship, it seems, is just never easy. Next, the third-date data showed an average of about one more satisfying sexual event per month, slightly more than women taking a placebo. No word on unsatisfying events.

Fully half the drugged women expressed satisfaction with the pill, which seems like a strikingly good outcome -- at least until you compare it to the 40% of the placebo group who also expressed similar satisfaction with their confection. Further, in one trial, although the event tally went north, there was no significant daily desire effect. So the quality of the interactions was better, but the libido itself remained mired, in between 'events.' Significant side effects bothered more than one in five trialists.

So, is this pill much good? Not really. And will this pill succeed? Absolutely -- this is America, after all, where our healthcare mantra is "why prevent it, when you can cure it with a pill?" So confident is somebody, that Sprout Pharmaceuticals, the start-up that achieved FDA approval, was immediately sold to a larger company, for a cool $Billion. Will it be cost-effective? I don't have pricing data, but it's safe to conclude that it'll cost more than placebo sugar pills. A LOT more. And cost-effective vs. other interventions like couples therapy? Entirely unknown.

So where does that leave us? My strictly amateur, unscientific position is that the human brain of both sexes is the primary seat of sexual desire and promoter of its performance. And I have it on excellent authority and experience that the best thing partners can do to augment their 'satisfying sexual events' tally is to be kind to each other.

As explained to me recently, and borne-out in my own clinical trial: "the sexiest thing a man can do is ? housework. "

* What ? should I have adapted Jagger and Richards' "Mother's Little Helper?"

I suggest that anybody interested in human sexuality consider reviewing the following:

. Lonnie Barbach, "For Yourself"

. Bernie Zilbergeld, "Male Sexuality, Revised Edition"

Both books provide an excellent overview of human sexuality in a compassionate manner. There is humor! At one time both Lonnie & Bernie were connected to the Human Sexuality Program, Department of Psychiatry, UCSF.

Dr. Harvey Kaplan was involved with Couples Sexuality at UCSF. There was also a program associated with Gay Sexuality at UCSF.

Incidentally, there was also a program at UCSF re: Sexuality and the Disabled. To the best of my recollection Ms.Sue Knight was the contact therapist.

Often, the primary problem is communication between partners. Some individuals are unable to identify their sexual needs and need help learning how to identify their needs, talk about their needs, and to ask their partner how to help them meet their needs.

It's best to review the books by Dr. Barbach and Dr. Zilbergeld. The sensate focus exercises are helpful and fun.

[This is good stuff, Cholo, but you absolutely need to consolidate your comments into one entry/idea. This is like stream-of-consciousness, and it drives folks away from your entries. --TFC]

T...I've had 2 strokes in the past so I don't always remember info at the time.
I'm not able to write with a pencil and I have trouble using a computer with both hands. Most of my problems have to do with memory and use of hands.

Will keep trying to improve.

[Thanks, Cholo! -- Email me if you want this one removed for privacy reasons -- TFC]

Bernie was my immediate supervisor at UCSF/Human Sexuality Program. He was a TOUGH cookie and supervised all of my individual/group cases. It was the most difficult learning experience that I've ever had. During weekly individual/group supervision, he grilled me. He was sooooooooo funny that even the most difficult times contained humor! That was one of our connections and while listening to my tapes on his way to work, he said that he laughed so hard that his eyes watered! In front of all the interns, he reviewed my tapes in front of everybody else during group supervision. I went from beet red to blue to bright brown. Everybody laughed and I just want to slither out of the conference room.

I was the intern that was selected to provide 2 groups and to present weekend Social Skills Groups. My co-facilitator was his girlfriend, Dr. R! What a high! My participation was a form of payment for all of training so I was connected to the program for 12 months.

Women, if you decide to take the pill then do so. However, I would advise that you read "For Yourself" by Dr. Barbach. She's a wonderful and compassionate woman. You will fall in love with her...I guarantee it!

Posted by Ed,
a resident of Pleasanton Meadows,
on Aug 31, 2015 at 8:00 am

I think that a couple of martinis will work just as well as this new "female viagra". Cheaper too and with none of the side affects of the pills.
All kidding aside, it seems to be a chemical mood elevator for women but maybe if the man were more romantic and patient that might to the trick too. Maybe too much time is being spent on social media, men are too distracted, too busy, too lazy, to properly court a woman and show her he really cares.
This pill sounds like a "fix" for the real issue.

Women are quite capable of satisfying their sexual needs. Some males are distracted but not all. How have you come to believe that males are responsible for a woman's sexual response? Women do not need males to satisfy all of their sexual needs.

Women have everything that it takes to satisfy themselves sexually. It's fun when such needs are shared with a partner but not necessary. Sorry fellas!

Some folks believe that their sexual relationships are best when they can share their sexual experiences with a partner. Not all couples/individuals agree.

Women have many options and if the pill is their answer, then go for it if it is safe for you. Have great fun and enjoy what has been given to you. You deserve nothing but the best.

Posted by Ed,
a resident of Pleasanton Meadows,
on Aug 31, 2015 at 12:58 pm

Women and men can certainly satisfy themselves sexually but that only takes into account the physical aspect. It's way more meaningful when love and romance are mixed in together with the physical activity. Sex is the highest expression of love, anything less than that puts us on the same plane as animals.
And I believe that women deserve to be pampered, romanced, and made to feel special in the eyes of the man they are with. Why not?
I think if that were to happen more often there wouldn't be any need to take a pill of some kind.